Individual
DR. BRADLEY TYLER HAGARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
475 N WALNUT ST, COLFAX, IA 50054-9600
(515) 674-4466
(515) 674-3123
Mailing address
PO BOX 155, COLFAX, IA 50054-0155
(515) 674-4466
(515) 674-3123
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7739
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1472043
—
IA
01
—
47116
BCBS
IA
Enumeration date
10/27/2006
Last updated
06/27/2023
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